Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lake Wilderness Medical Clinic LLC

Organization Medical Specialty Clinic/Center · NPI 1669647152

Lake Wilderness Medical Clinic LLC is a Medical Specialty Clinic/Center in Maple Valley, Washington. Licensed in Washington. Registered with an NPI since 2008.

Licensed in
WA
In the registry since
2008
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

26907 Maple Valley Black Diamond Rd SE
Maple Valley, WA 98038-8314
Phone: (425) 432-9611
Fax: (206) 973-5399
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Specialty Clinic/Center (primary) Taxonomy 261QM2500X · Licence 602777613 (WA)

Record details

NPI number1669647152
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chester Jangala — Physician · (425) 432-9611
Other names Chet Jangala, Md
NPI enumeratedApril 25, 2008
Last updated in NPPESApril 25, 2008
Mailing addressPo Box 1142, Ravensdale, WA 98051-1142